Running head: URINARY CATHETER INSERTION

Urinary Catheter Insertion: Reducing Infection

Ken N. Snell
Ferris State University

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2
Abstract

This paper describes urinary catheters, a nurses responsibility to advocate for their patients, use
proper technique and stay current in the most recent guidelines to provide good quality
evidenced based care. Watsons nursing theory, The Attending Caring Nurse incorporates best
professional care for the patient while integrating the person, family and health care staff (ACN)
(Watson & Foster, 2003, p.363).

Urinary Catheter Insertion: Reducing Infection

Nurses have heard in the news all too often about the risks of hospital acquired infections.
There are many ways to get an infection while in the hospital, however according to Oman et al.
(2012) catheter associated urinary tract infections (CAUTIs) account for more than 30% of these
infections (p.548). Nursing interventions along with following established guidelines can
significantly reduce the amount of CAUTIs in hospitals.
Advocate for patients

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Nursing has a responsibility to not only care for our patient, but also advocate for what is
in the patients best interest. Before initiating a catheter nurses should ask themselves, does the
patient really need a catheter, is this in the patients best interest, or is there an alternative to
catheterization? If this is procedure is considered the best alternative for the given situation, then
the nurse must proceed by using the proper sterile techniques with the initiation of the catheter.
Proper Technique
Nursing interventions such as proper hand washing, setting up of necessary equipment,
perineal cleaning prior to catheter insertion and using a sterile field are critical for decreasing
CAUTIs. When done correctly, the proper setup and management of the catheter can reduce
incidence of infection. The Center for Disease Control and Prevention (CDC) (2009) published
guidelines concerning prevention of CAUTIs. Nursing staff must stay current with education and
practice by using the most reliable techniques in order to give high quality safe care.

Education
One of the CDC recommendations is that hospital personnel should be given periodic
in-service training related to proper techniques, complications of catheters and when to use and
not use urinary catheters. According to Burnett et al. (2010) education programs such as these
are significant to nursing because they increase knowledge and competency, significant to an
organization because it will assist in the prevention of infection and significant to the patient
whom will be less likely to acquire an infection and will have increased safety (p.548).
Nursing Theory
Caring for a patient, mindful of what is in the patients best interest, creating a plan of care
from the patients point of view, incorporating the medical point of view, communicating with

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medical staff, patients and patients family is part of The Attending Caring Nurse (ACN) (Watson
& Foster, 2003, p.363). There may be times when a urinary catheter order is placed because a
patient is incontinent, however the patient is able to get up and move to the commode or
bathroom. Is it in the patients best interest to stay in bed? There are several issues that must be
taken into account when placing a catheter in a patient. Catheters place a patient at risk of
infection, higher risk of falls, decreases their mobility and places them at a higher risk of skin
issues. Nurses not only have to stay current in their own education but they also must educate
staff, patients and families as to what is the best alternative for the given situation.
Conclusion
Hospital acquired infections are unfortunately an issue that is ever present in our current
health care system. As nurses it is our responsibility to strive for better outcomes for our patients.
We must continue to move forward in our education and utilize the best practices. In addition, we
also need to encourage other health care staff to work on finding ways to give safer alternatives
to patients which will assure that we provide excellent quality of care for everyone. We must
have an open level of communication with staff, patients and their families in our attempt to
always reach for what is in our patients best interest.

References
Center for Disease Control and Prevention. (2009). Guideline for prevention of catheter
associated urinary tract infections 2009. Retrieved from
http://www.cdc.gov/hicpac/pdf/CAUTI/CAUTIguideline2009final.pdf

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Oman, K. S., Makic, M. B., Fink, R., Schraeder, N., Hulett, T., Keech, T., & Wald, H. (2012).
Nurse-directed interventions (Burnett et al., 2010) to reduce catheter-associated urinary
tract infections. American Journal of Infection Control, 40, 548-553.
doi:10.1016/j.ajic.2011.07.018
Scott, R. A., Omen, K. S., Makic, M. B., Fink, R. M., Hulett, T. M., Braaten, J. S.,...Wald, H. L.
(2014). Reducing indwelling urinary catheter use in the Emergency Department: A
Successful quality improvement initiative. Journal of Emergency Nursing, 40, 3,237-244.
doi:10.1016/j.jen.2012.07.022
Watson, J., & Foster, R. (2003). The Attending Nurse Caring Model: Integrating theory, evidence
and advanced caring-healing therapeutics for transforming professional practice. Journal
of Clinical Nursing, 12, 360-365. doi:10.1046/j.1365.2702.2013.00774.x/epdf